Refraction, anterior chamber depth, decentration, and tilt after implantation of monofocal and multifocal silicone intraocular lenses

Background. We prospectively investigated changes in refraction, anterior chamber depth,decentration and tilt after implantation of multifocal (MIOL) and monofocal (MONO) intraocular lenses (IOL). Patients and methods. We examined 103 cataractous eyes from 103 patients receiving either a three-piece monofocal or multifocal silicone IOL. Anterior chamber depth (ACD), amount of IOL decentration, and degree of IOL tilt were quantified using retroillumination and Scheimpflug photographs. Examinations, including subjective refraction, were performed preoperatively,one week and 6 months postoperatively. Results. Ail eyes were within 2 dpt (spherical equivalent) from the target refraction, and 93% of eyes with a MIOL were within 1 dpt. No significant refractive shift or ACD change occurred during the postoperative course. Median tilt in the MIOL group at 6 months was 1.1 degrees (0-2.6) and that in the MONO group 1.0 degrees (0-2.5). There was no statistically significant change in intraindividual IOL decentration or tilt. Conclusion. Three-piece silicone MIOLs and MONOs with polymethylmethacrylate haptics implanted in the capsular bag after circular capsulorhexis provide good centration and very little tilt without statistically significant change up to 6 months after surgery. Postoperative refractive shift is of minor concern for 6 months after surgery.